1. Research Activities Five studies are proposed: a. Examine the impact of having a household member with COPD and /or CVD on household functioning and propensity to experience impoverishment. Rural (1,200 patients) and urban ( 1,200 patients)= 2,400 total b. Examine health seeking behavior and health provider responses for COPD and CV conditions. Two rural areas (2,400 patients) and one urban (1,200 patients)= 3,600 patients total c. Population based study of prevalence and determinants of COPD and assessment of the rate of decline in pulmonary function in COPD cases in rural and urban settings. Rural (4,500 patients) and urban ( 4,500 patients)= 9,000 patients total d. Prevalence of arterial hypertension and the associated factors among adults (>26 years old) in rural and urban areas. 9,000 individuals total. e. Chronic diseases and poverty in Matlab; Risks and trends. Cohort analysis of 13,000 households (~65,000 people) that have been followed through the Matlab demographic surveillance system dorm 1982 to 2005. 2. Training Three activities are proposed: a. Add an MS in Public Health and provide stipend for 3 students each year b. Offer 6 scholarships to students committed to the study of CVPD in the new doctor of publish health program c. Offer 10 post doctoral opportunities to pursue research on chronic CVPD.